Unlike a great many people in this country, I have no idea how to design an efficient and effective health-care system that would serve all who need it, or can afford it, or whatever the criterion is. I’m constantly astonished at the quantity of people who seem to believe that they do. Perhaps that’s not quite correct, though. A large proportion of those with a strong opinion are apparently content simply to oppose whatever is being proposed at the moment. That’s not quite what I would call an idea.

An interesting and perhaps even instructive sidelight on our current system has gradually dawned on me, though, while watching television. Perhaps you’ve noticed it, too. There are a great many commercial messages urging me, or you, or someone, to use some particular drug. I don’t mean aspirin or acne cream or Carter’s or Doan’s pills or even Mrs. Lydia Pinkham’s 36-proof tonic. No, I mean prescription drugs, the ones you have to have the doctor’s permission to use and for which you or your insurance company pays quite noticeable bucks.

The problems for which the various drugs on offer ostensibly provide solutions range from the life-threatening to the trivial. It is the genius, if that is the word, of marketing to make them all seem equally serious. Thus we get testimonials from fellows who have suffered heart attacks…

(Digression: Next time you see one of those guys, “Steve A.” of New York, who hopes at the end of his commercial that we will all benefit from his experience, cover the top half of his face and see what old movie star he resembles. *Answer below.)

…and from women whose eyelashes are too sparse. A number of drugs have to do with urination, aimed at gentlemen who have trouble squeezing it out or at ladies who can’t hold it in. And then there are the drugs for allergies, for acid reflux, for menstrual distress of one sort or another, and, of course, the ones for the so-popular erectile dysfunction. Remember, fellows, four hours is your limit.

There are two elements you can expect in all these commercials. First is the advice to tell your doctor if you have liver or kidney disease before pestering him for a prescription. I’ve asked this before, but shouldn’t your doctor know this? Isn’t he or she the one who is supposed to tell you if you have liver or kidney or any other disease? I can only guess that this caution is directed to people who shop for compliant prescribers.

The second standard element, of course, is the high-speed recitation at the end of the various unpleasant side-effects that the drug may cause: dry mouth, muscle pain, headache, dizziness, death. Forewarned is forearmed, I guess.

Here’s the bit that is interesting, to me anyway. Increasingly I am also seeing commercials for law firms that are trolling for people who believe or can be persuaded that they have suffered some harm as a result of taking this or that prescription drug. These ads are cheaply made and are more often seen on cable channels than on the major networks. They sometimes feature a spokesperson who may or may not be a lawyer but might as well be because he or she seems obviously shady. The pitch is usually hard-sell and sometimes unintentionally funny, as when you are urged to call if you have suffered injury or death.

Let’s summarize:

1. The pharmaceutical companies invest huge sums in development and testing and then patent their drugs so as to be able to charge monopoly prices to recoup the investment.

2. They then pay more megabucks to air commercials to induce you to nag your doctor for a drug you may not need.

3. The lawyers air commercials to induce you to join a class action suit for multimegabucks against the pharmaceutical company.

4. Win or lose, the cost of defending the suit forces the company to raise prices.

5. Your insurance company raises your premium or just drops the drug from its approved list.

And the winner is: Apart from the ad agency and TV people, I dunno.

And there you are, innocently sitting in your easy chair and watching TV.